Adrenal and Pituitary Insufficiency in the Neonate

Abstract

Adrenal and pituitary deficiency can present catastrophically with shock and cardiopulmonary arrest or gradually with lethargy and failure to thrive. Lifesaving treatment is safe and simple, and timely recognition of the disorder minimizes the likelihood of death or permanent brain injury from hypoglycemia and hypothyroidism. This article reviews the major causes and clinical presentations of adrenal and pituitary deficiency states in the newborn period as well as evaluation of pituitary and adrenal function and the principles of endocrine replacement therapy.